EP3743010B1 - Diagnostische intraorale abtastung und verfolgung - Google Patents

Diagnostische intraorale abtastung und verfolgung Download PDF

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Publication number
EP3743010B1
EP3743010B1 EP19707522.9A EP19707522A EP3743010B1 EP 3743010 B1 EP3743010 B1 EP 3743010B1 EP 19707522 A EP19707522 A EP 19707522A EP 3743010 B1 EP3743010 B1 EP 3743010B1
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Prior art keywords
patient
dental arch
model
dental
viewing window
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EP19707522.9A
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English (en)
French (fr)
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EP3743010A1 (de
Inventor
Michael SABINA
Avi Kopelman
Eric Kuo
Gilad Elbaz
Assaf Weiss
Doron Malka
Ofer Saphier
Eliahou Franklin NIZARD
Ido TISHEL
Shai Ayal
Maayan MOSHE
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Align Technology Inc
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Align Technology Inc
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Priority to EP22150711.4A priority Critical patent/EP4056145A1/de
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00002—Operational features of endoscopes
    • A61B1/00004—Operational features of endoscopes characterised by electronic signal processing
    • A61B1/00009—Operational features of endoscopes characterised by electronic signal processing of image signals during a use of endoscope
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    • A61B1/00002—Operational features of endoscopes
    • A61B1/00004—Operational features of endoscopes characterised by electronic signal processing
    • A61B1/00009—Operational features of endoscopes characterised by electronic signal processing of image signals during a use of endoscope
    • A61B1/000094—Operational features of endoscopes characterised by electronic signal processing of image signals during a use of endoscope extracting biological structures
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    • A61B1/00002—Operational features of endoscopes
    • A61B1/00004—Operational features of endoscopes characterised by electronic signal processing
    • A61B1/00009—Operational features of endoscopes characterised by electronic signal processing of image signals during a use of endoscope
    • A61B1/000096—Operational features of endoscopes characterised by electronic signal processing of image signals during a use of endoscope using artificial intelligence
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    • A61B1/06—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements
    • A61B1/0638—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements providing two or more wavelengths
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    • A61B5/0084—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes for introduction into the body, e.g. by catheters
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    • A61B5/0088—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes for oral or dental tissue
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    • A61B5/45—For evaluating or diagnosing the musculoskeletal system or teeth
    • A61B5/4538—Evaluating a particular part of the muscoloskeletal system or a particular medical condition
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/50—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment specially adapted for specific body parts; specially adapted for specific clinical applications
    • A61B6/51—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment specially adapted for specific body parts; specially adapted for specific clinical applications for dentistry
    • A61B6/512—Intraoral means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C13/00—Dental prostheses; Making same
    • A61C13/0003—Making bridge-work, inlays, implants or the like
    • A61C13/0004—Computer-assisted sizing or machining of dental prostheses
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    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C13/00—Dental prostheses; Making same
    • A61C13/0003—Making bridge-work, inlays, implants or the like
    • A61C13/0006—Production methods
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    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C13/00—Dental prostheses; Making same
    • A61C13/34—Making or working of models, e.g. preliminary castings, trial dentures; Dowel pins [4]
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C5/00—Filling or capping teeth
    • A61C5/50—Implements for filling root canals; Methods or instruments for medication of tooth nerve channels
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C7/00—Orthodontics, i.e. obtaining or maintaining the desired position of teeth, e.g. by straightening, evening, regulating, separating, or by correcting malocclusions
    • A61C7/002—Orthodontic computer assisted systems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C9/00—Impression cups, i.e. impression trays; Impression methods
    • A61C9/004—Means or methods for taking digitized impressions
    • A61C9/0046—Data acquisition means or methods
    • A61C9/0053—Optical means or methods, e.g. scanning the teeth by a laser or light beam
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T19/00—Manipulating 3D models or images for computer graphics
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T2200/00—Indexing scheme for image data processing or generation, in general
    • G06T2200/24—Indexing scheme for image data processing or generation, in general involving graphical user interfaces [GUIs]
    • G—PHYSICS
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    • G06T2207/30—Subject of image; Context of image processing
    • G06T2207/30004—Biomedical image processing
    • G06T2207/30036—Dental; Teeth
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T2210/00—Indexing scheme for image generation or computer graphics
    • G06T2210/41—Medical

Definitions

  • the method also includes adjusting, by a user, or in response to user input, the weighted portion of the surface color values and/or the near-IR transparency of the internal structures.
  • Generating the 2D view may comprises sectioning the 3D volumetric model in a plane through the 3D volumetric model.
  • the user may select the plane's location and/or orientation, and my do this in a continuous manner.
  • any of these methods may include selecting, by a user, a section though the 3D volumetric model to display, wherein selecting comprises continuously selecting sections through the 3D volumetric model as the user scans through the 3D model and continuously displaying the 2D views corresponding to each section.
  • Generating the 2D view may comprises selecting, by a user, an orientation of the 2D view.
  • generating the two-dimensional (2D) view through the 3D volumetric may also include including in the 2D view a weighted portion of the surface values and a weighted portion of the near-IR transparency of the internal structures.
  • the weighted portion of the surface values may include a percentage of the full value of the surface values
  • the weighted portion of the near-IR transparency of the internal structures comprises a percentage of the full value of the near-IR transparency of the internal structures, wherein the percentage of the full value of the surface values and the percentage of the full value of the near-IR transparency of the internal structures adds up to 100%.
  • the user may adjust the weighted portion of one or more of the surface values and the near-IR transparency of the internal structures.
  • Monitoring of one or more internal regions of the teeth over time (non-claimed) using the volumetric models of the patient's teeth taken with the devices described herein may be particularly helpful for predicting dental problems, including caries, cracks, tooth loss, gum recession, and the like.
  • these methods and apparatuses may help the user (e.g., dentist, dental technician, orthodontist, etc.) inform and educate a patient so that the patient may take recommended treatments prior to developing more serious problems.
  • pre-cavitated caries are difficult to identify with current imaging techniques, and it may be particularly difficult to convince a patient to treat even when identified, since they typically present without pain.
  • early stage treatment may be critical to avoiding more complicated and dangerous procedures later.
  • the plaque and calculus may have a different absorption/reflection than enamel. This may allow the calculus and/or plaque to be differentiated from the enamel in the volumetric model. Further, the volumetric model may be used to detect material on the teeth, including calculus and plaque based on the surface smoothness and geometry. In variations in which calculus and/or plaque are not transparent to the near-IR frequencies used, the apparatus may differentiate calculus and/or plaque from the enamel using the volumetric model. Thus, the calculus and/or plaque may be segmented and differentiated from enamel.
  • the scanner may then be used to evaluate the preparation 717, on in some cases this step may be integrated fully into the guided prep step 715, therefore removing the need for the post-prep evaluation.
  • CAD/CAM may be used to prepare the crown (or other dental appliance) for the correctly prepared tooth 719.
  • the morphology of the dental arch may be used to help identify the likely areas of interest or potential issues.
  • the 3D model (volumetric model) may be used and/or modified as described herein in order to include the regions of potential actionable dental features.
  • a modified 3D model may act as a map that visually indicates areas of areas for risk assessment; this may be used, for example, to guide treatment of the patient, including to promote use of sealants, orthodontic treatment or night guards, etc.
  • the modified 3D model may be used to guide a user when additional scans are needed (e.g., when there is a low number of scans in the risk areas).
  • a modified 3D model may include a 3D (e.g., volumetric and/or surface) model that has been marked to indicate the locations and/or type and/or confidence level of potential actionable dental features.
  • a 3D model e.g., volumetric and/or surface
  • the use of additional data sources to guide users to capture potential areas of interest may help confirm findings of potential actionable dental features.
  • the results, including a modified 3D model may help guide the user in scanning or re-scanning (at a future time) the user's dentition. For example, historical scans can be used as a targeting map while scanning (and to confirm adequate coverage in those areas).

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  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Radiology & Medical Imaging (AREA)
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Claims (15)

  1. Verfahren, umfassend:
    Anzeigen eines dreidimensionales (3D) Modells (617) eines Zahnbogens eines Patienten;
    Anzeigen eines Sichtfensters (1003, 1005) über mindestens einen Abschnitt des 3D-Modells des Zahnbogens des Patienten, wobei ein Anzeigen des Sichtfensters (1003, 1005) über einen Abschnitt des 3D-Modells des Zahnbogens des Patienten ein Anzeigen einer Schleife (1401) umfasst, durch die der Abschnitt des 3D-Modells des Zahnbogens des Patienten betrachtet werden kann;
    Empfangen, von einem Benutzer, einer Änderung einer relativen Position zwischen dem Sichtfenster (1003, 1005) und dem 3D-Modell (617) des Zahnbogens des Patienten; Identifizieren, sowohl aus dem 3D-Modell (617) des Zahnbogens des Patienten als auch aus einer Vielzahl von Bildern des Zahnbogens des Patienten, die aus verschiedenen Winkeln und Positionen in Bezug auf den Zahnbogen des Patienten aufgenommen werden, eines Nahinfrarotbilds (1005), das unter einem Winkel und einer Position aufgenommen wird, die sich einem relativen Winkel und einer relativen Position zwischen dem Sichtfenster (1003, 1005) und dem 3D-Modell des Zahnbogens des Patienten annähert; und
    Anzeigen des identifizierten Nahinfrarotbilds (1005), das in einem Winkel und an einer Position aufgenommen wird, die sich dem Winkel und der Position zwischen dem Sichtfenster (1003) und dem 3D-Modell (617) des Zahnbogens des Patienten annähern.
  2. Verfahren nach Anspruch 1, wobei die Schritte eines Identifizierens des Nahinfrarotbilds und eines Anzeigens des identifizierten Nahinfrarotbilds kontinuierlich durchgeführt werden, wenn der Benutzer die relativen Positionen zwischen dem Sichtfenster und dem 3D-Modell des Zahnbogens des Patienten ändert.
  3. Verfahren nach Anspruch 1, wobei ein Ermöglichen, dass der Benutzer die relative Position zwischen dem Sichtfenster und dem 3D-Modell des Zahnbogens des Patienten ändert, ein Ermöglichen umfasst, dass der Benutzer eines oder mehrere von Folgenden ändert: einen Winkel zwischen einer Ebene des Sichtfensters und dem Zahnbogen des Patienten und einen Abschnitt des Zahnbogens angrenzend an das Sichtfenster.
  4. Verfahren nach Anspruch 1, wobei ein Identifizieren ein Bestimmen einer Vielzahl von Bildern, die sich dem relativen Winkel und der Position zwischen dem Sichtfenster relativ und dem 3D-Modell des Zahnbogens des Patienten annähern, und ein Mitteln der Vielzahl umfasst, um das identifizierte Nahinfrarotbild zu bilden.
  5. Verfahren nach Anspruch 1, ferner umfassend ein Sammeln, in einem Prozessor, eines Datensatzes, umfassend sowohl das 3D-Modell des Zahnbogens des Patienten als auch die Vielzahl von Bildern des Zahnbogens des Patienten, die in verschiedenen Winkeln und Positionen in Bezug auf den Zahnbogen des Patienten aufgenommen werden.
  6. Verfahren nach Anspruch 1, wobei ein Ermöglichen, dass der Benutzer die relative Position zwischen dem Sichtfenster und dem 3D-Modell des Zahnbogens des Patienten ändert, ein separates Steuern eines oder mehrerer von Folgenden umfasst: den Winkel des 3D-Modells des Zahnbogens eines Patienten, die Drehung des 3D-Modells des Zahnbogens eines Patienten und den Abschnitt des Zahnbogens angrenzend an das Sichtfenster.
  7. Verfahren nach Anspruch 1, ferner umfasst ein Identifizieren, sowohl aus dem 3D-Modell des Zahnbogens des Patienten als auch aus der Vielzahl von Bildern des Zahnbogens des Patienten, die in verschiedenen Winkeln und Positionen in Bezug auf den Zahnbogen des Patienten aufgenommen werden eines zweiten Bilds, das sich dem relativen Winkel und der relativen Position zwischen dem Sichtfenster relativ und dem 3D-Modell des Zahnbogens des Patienten annähert, ein Identifizieren eines von Folgenden umfasst: eines Bilds sichtbaren Lichts und eines Fluoreszenzbilds; und Anzeigen des zweiten Bilds gleichzeitig mit dem Nahinfrarotbild.
  8. Verfahren nach Anspruch 1, wobei ein Anzeigen des identifizierten Nahinfrarotbilds, das sich dem Winkel und der Position des Sichtfensters in Bezug auf das angezeigte 3D-Modell annähert, ein Anzeigen des identifizierten Nahinfrarotbilds in einem Fenster umfasst, das an die Anzeige des 3D-Modells des Zahnbogens des Patienten angrenzt oder sich damit überschneidet.
  9. Intraorales Scansystem, System zum Ausführen des Verfahrens nach Anspruch 1, das System umfassend:
    einen handgehaltenen Stab (1702), der mindestens einen Bildsensor (285) und eine Lichtquelle (109), die konfiguriert ist, um Licht in einem Spektralbereich innerhalb des Nahinfrarot-Wellenlängenbereichs emittiert, aufweist;
    eine Anzeigeausgabe (119);
    eine Vorrichtung für Benutzereingabe (121); und
    einen oder mehrere Prozessoren, die funktionsfähig mit dem handgehaltenen Stab (1702), der Anzeigeausgabe (119) und der Vorrichtung für Benutzereingabe (121) verbunden sind, wobei der eine oder die mehreren Prozessoren zu Folgendem konfiguriert sind: Anzeigen eines dreidimensionalen (3D) Modells (617) eines Zahnbogens eines Patienten an der Anzeigeausgabe (119);
    Anzeigen eines Sichtfensters (1003, 1005) über einen Abschnitt des 3D-Modells (617) des Zahnbogens des Patienten an der Anzeigeausgabe, wobei ein Anzeigen des Sichtfensters (1003, 1005) über einen Abschnitt des 3D-Modells (617) des Zahnbogens des Patienten ein Anzeigen einer Schleife (1401) umfasst, durch die der Abschnitt des 3D-Modells (617) des Zahnbogens des Patienten betrachtet werden kann;
    Ändern einer relativen Position zwischen dem Sichtfenster (1003, 1005) und dem 3D-Modell des Zahnbogens des Patienten basierend auf Eingaben von der Benutzereingabevorrichtung;
    Identifizieren, sowohl aus dem 3D-Modell des Zahnbogens des Patienten als auch aus einer Vielzahl von Bildern des Zahnbogens des Patienten, die aus verschiedenen Winkeln und Positionen in Bezug auf den Zahnbogen des Patienten aufgenommen werden, eines Nahinfrarotbilds, das unter einem Winkel und einer Position aufgenommen wird, die sich einem relativen Winkel und einer relativen Position zwischen dem Sichtfenster relativ und dem 3D-Modell des Zahnbogens des Patienten annähert; und
    Anzeigen des identifizierten Nahinfrarotbilds (1005), das in einem Winkel und an einer Position aufgenommen wird, die sich dem Winkel und der Position zwischen dem Sichtfenster (1003) relativ und dem 3D-Modell (617) des Zahnbogens des Patienten annähern.
  10. Intraorales Scansystem nach Anspruch 9, wobei der eine oder die mehreren Prozessoren konfiguriert sind, um die Vielzahl von Bildern des Zahnbogens des Patienten zu empfangen, die in verschiedenen Winkeln und Positionen in Bezug auf den Zahnbogen des Patienten aufgenommen werden.
  11. Intraorales Scansystem nach Anspruch 9, wobei der eine oder die mehreren Prozessoren konfiguriert sind, um das Nahinfrarotbild kontinuierlich zu identifizieren und das identifizierte Nahinfrarotbild anzuzeigen, wenn der Benutzer die relativen Positionen zwischen dem Sichtfenster und dem 3D-Modell des Zahnbogens des Patienten ändert.
  12. Intraorales Scansystem nach Anspruch 9, wobei der eine oder die mehreren Prozessoren konfiguriert sind, um die relative Position zwischen dem Sichtfenster und dem 3D-Modell des Zahnbogens des Patienten basierend auf Eingaben von der Benutzereingabevorrichtung zu ändern, indem sie eines oder mehrere von Folgenden ändern: einen Winkel zwischen einer Ebene des Sichtfensters und dem Zahnbogen des Patienten und einen Abschnitt des Zahnbogens angrenzend an das Sichtfenster.
  13. Intraorales Scansystem nach Anspruch 9, wobei der eine oder die mehreren Prozessoren konfiguriert sind, um das Nahinfrarotbild zu identifizieren, das in einem Winkel und einer Position aufgenommen wird, die sich einem relativen Winkel und einer relativen Position zwischen dem Sichtfenster in Bezug auf das 3D-Modell des Zahnbogens des Patienten annähern, indem sie eine Vielzahl von Bildern bestimmen, die sich dem relativen Winkel und der relativen Position zwischen dem Sichtfenster relativ und dem 3D-Modell des Zahnbogens des Patienten annähern, und Mitteln der Vielzahl, um das identifizierte Nahinfrarotbild zu bilden.
  14. Intraorales Scansystem nach Anspruch 9, wobei der eine oder die mehreren Prozessoren konfiguriert sind, um die relative Position zwischen dem Sichtfenster und dem 3D-Modell des Zahnbogens des Patienten basierend auf Eingaben von der Benutzereingabevorrichtung zu ändern, indem sie eines oder mehrere von Folgenden ändern: den Winkel des 3D-Modells des Zahnbogens eines Patienten in Bezug auf das Sichtfenster, die Drehung des 3D-Modells des Zahnbogens eines Patienten in Bezug auf das Sichtfenster und den Abschnitt des Zahnbogens angrenzend an das Sichtfenster.
  15. Intraorales Scansystem nach Anspruch 9, wobei der eine oder die mehreren Prozessoren konfiguriert sind, um sowohl aus dem 3D-Modell des Zahnbogens des Patienten als auch aus der Vielzahl von Bildern des Zahnbogens des Patienten, die in unterschiedlichen Winkeln und Positionen in Bezug auf den Zahnbogen des Patienten aufgenommen werden, ein zweites Bild zu identifizieren, das sich dem relativen Winkel und der relativen Position zwischen dem Sichtfenster relativ und dem 3D-Modell des Zahnbogens des Patienten annähert das eines oder mehrere von Folgenden ist: ein Bild sichtbaren Lichts und ein Fluoreszenzbild; und wobei der eine oder die mehreren Prozessoren konfiguriert sind, um das zweite Bild gleichzeitig mit dem Nahinfrarotbild anzuzeigen.
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